Payor Specialist

Purpose:

The Payor Specialist role involves a blend of clerical, secretarial, and payor-related tasks. You'll be part of a warm and welcoming team that fosters a wonderful working culture and environment. Our typical work hours are 8:30 AM to 5:00 PM, Monday through Friday, with occasional weekend shifts (currently once every 3 months). This position is on site in Harrisburg, PA.

Responsibilities:

• Notify payors of admissions and discharges.

• Communicate payor issues and concerns to care managers, documenting interactions in Canopy.

• Assist with denial management processes, including concurrent and retrospective denials and appeals.

• Provide prompt payor feedback to care managers and social workers to optimize patient care.

• Obtain payor benefit verification for post-acute services.

• Maintain authorization/certification information in Canopy and Medipac System.

• Support the payer call center for authorization requests.

• Adhere to hospital policies and demonstrate Service Excellence behaviors.

• High school diploma or equivalent and one year of claims, billing, or collections experience

• OR 4 years in a business office setting

• OR Bachelor's degree

• OR equivalent combination of education and experience.

• Excellent communication skills, both written and verbal.

• Coordination and interpersonal skills along with the ability to exercise independent judgment.

• Thorough knowledge of Microsoft Work, Excel, Access and PowerPoint is required. Licensure, Certifications, and Clearances:

• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran